NPIMap

Individual provider Active NPI

Jenna Lynn Warden, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1629522339
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010147 Issued in NC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-0720
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 5010147 NC
Acute Care Nurse Practitioner 363LA2100X 5010147 NC
Gerontology Nurse Practitioner 363LG0600X 5010147 NC
Nurse Practitioner 363L00000X 5010147 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

920 Church St N
Suite 255
Concord, NC 28025-2927
Phone (704) 403-1331

Other practice location 2

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6241

Other practice location 3

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Other practice location 4

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 304-6070

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jwarden631533@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180621002216 NC Practitioner - Nurse Practitioner 6507144037 Reassigns benefits to 2 organizations
I20180905003650 SC Practitioner - Nurse Practitioner 6507144037 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1000 Wellness Way
Fort Mill, SC 29715-7315
Phone (803) 329-1234

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.91 of 100Reported as group
Improvement activities
40
Cost
85.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010147NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC Hospital Medicine Physicians LLC CurrentSince Mar 1, 2023 Accepting new patients
Southeastern Hospitalist Services PC Hospitalist CurrentSince Feb 1, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Feb 19, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Columbus Regional Health Network CurrentSince Feb 19, 2018 Accepting new patients
Columbus Regional Health Network Hospitalist CurrentSince Feb 19, 2018 Accepting new patients
Cogent Healthcare of Georgia PC Hospitalist CurrentSince Jun 10, 2018 Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince Feb 19, 2018 Accepting new patients
Columbus Regional Health Network Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients
Gulf Coast Pulmonary Medicine PastSince Aug 22, 2016 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

1000 Blythe Blvd
Fl 1
Charlotte, NC 28203
Phone (704) 355-0720

487 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 403-0100

920 Church St N
Ste 255
Concord, NC 28025
Phone (704) 403-1331

920 Church St N
Ste 255B
Concord, NC 28025
Phone (704) 403-1331

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

1 Medical Park Dr
Chester, SC 29706
Phone (803) 581-3151

800 W Meeting St
Lancaster, SC 29720
Phone (803) 286-1214

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • Direct secure messaging: jwarden631533@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1629522339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-0720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Church St N",
            "address_2": "Suite 255",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-1331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8800 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623300",
            "country_code": "US",
            "telephone_number": "704-863-6241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10628 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-667-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Vail Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-304-6070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "5010147",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5010147",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5010147",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwarden631533@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1000 Blythe Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.